CHARACTER OF THE HEART-SOUNDS AND BRUITS. 139 



that surround that orgau, such as thrckeaiag of the lung-sections 

 or swards on the pleura. 



The dull sound is absent in enlargement of the lungs by emphy- 

 sema, when air has entered the pericardium, after injuries, in one- 

 sided pleuritis, in pneumothorax, and the sound is anteriorly 

 situated in the chest when there is intense meteorization of the 

 stomach or intestines, and in ascites. 



Character of the Heart-pulsations. 



The pulsations of the heart can be distinguished by putting the 

 hand on the inferior portion of the chest near the sternum, about 

 the fifth rib (on the right side the pulsation is a little more ante- 

 riorly situated). The pulsation makes a distinct vibration of all 

 the adjacent parts, and in emaciated animals there can be noticed 

 with each pulsation a distinct swelling or motion of the lower por- 

 tions of the ribs; this vibration may be greatly lessened by the 

 presence of layers of fat on the sides of the chest. After great 

 exertion or excitement the strength of the pulsation against the 

 chest-wall is greatly increased. 



The pulsations of the heart are increased by disease in the fol- 

 lowing manner : After considerable loss of blood, in any case of 

 fever, in palpitation of the heart, in some forms of heart-disease, 

 in hypertrophy of the heart, by the influence of some poisons, 

 like digitalis or aconite. It is almost imperceptible in degen- 

 eration of the muscle of the heart, in the later stages of acute 

 diseases, in cases of poisoning, in fatty degeneration of the heart 

 and when the heart has become compressed by the effects of hydro- 

 thorax, pneumo-pericarditis, or emphysema of the lungs. It is 

 distinguished only on the healthy side in lateral pleuritis. 



Character of the Heart-sounds and Bruits. 



In order to distinguish the heart-sounds we must put the ear 

 close to the side directly over the heart where the beats are loud- 

 est; it is better to cover the place with a handkerchief or cloth, 

 or we may use a stethoscope. We should hear two sounds in each 

 heart-beat — a systolic, which corresponds to the ventricular contrac- 

 tion, and a diastolic, which corresponds with the beginning of the 

 diastole. Both these sounds follow each other with short intervals 

 between. The pause between the first and second sound is short, 



